Lose the Hardware: The Rise of Leadless Modular Cardiac Pacing
- 1Division of Cardiology-Section of Electrophysiology, Emory University School of Medicine, Atlanta, GA 30322, USA
Abstract
Leadless pacemakers have reshaped the approach to cardiac pacing by eliminating transvenous leads and subcutaneous pockets. Since the introduction of the first leadless pacemakers, leadless pacing has advanced from single-chamber ventricular systems to atrioventricular synchronous pacing, standalone atrial pacing, and fully leadless dual-chamber platforms, enabling patient-tailored pacing therapy. The modular leadless pacing concept allows a standalone leadless pacing device to be implanted initially, with additional leadless devices added sequentially as pacing requirements evolve, minimizing unnecessary hardware while preserving the option for future pacing upgrades. This modular approach has expanded to include integration with subcutaneous implantable cardioverter-defibrillators and leadless cardiac resynchronization therapy, moving towards a fully leadless cardiac rhythm management ecosystem. This review summarizes the evolution of leadless pacing, compares currently available devices and their clinical applications, explains leadless pacemaker implantation and end-of-life management, and explores the modular leadless pacing concept as the foundation for future fully leadless cardiac rhythm management.
Related
- Atrial leadless pacing for heart failure in sick sinus syndrome
- Endomyocardial biopsy after leadless pacemaker implantation in patient with suspected cardiac amyloidosis
- Conduction System Pacing Versus Biventricular Pacing for Cardiac Resynchronization Therapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
- TRPM4-related left bundle branch block-induced cardiomyopathy reversed by left bundle branch area pacing-based cardiac resynchronization therapy: a case report.
- Restitution properties during ventricular fibrillation and the effects of cardiac pacing location on ventricular electrophysiology in the rabbit heart.
BibTeX
@article{almir2026lose,
title = {{Lose the Hardware: The Rise of Leadless Modular Cardiac Pacing}},
author = {Mohamad Al-Mir and Mikhael F. El-Chami},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207806},
url = {https://www.mdpi.com/2077-0383/15/20/7806},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Lose the Hardware: The Rise of Leadless Modular Cardiac Pacing
AU - Mohamad Al-Mir
AU - Mikhael F. El-Chami
PY - 2026
DA - 2026/10/10
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207806
UR - https://www.mdpi.com/2077-0383/15/20/7806
AB - Leadless pacemakers have reshaped the approach to cardiac pacing by eliminating transvenous leads and subcutaneous pockets. Since the introduction of the first leadless pacemakers, leadless pacing has advanced from single-chamber ventricular systems to atrioventricular synchronous pacing, standalone atrial pacing, and fully leadless dual-chamber platforms, enabling patient-tailored pacing therapy. The modular leadless pacing concept allows a standalone leadless pacing device to be implanted initially, with additional leadless devices added sequentially as pacing requirements evolve, minimizing unnecessary hardware while preserving the option for future pacing upgrades. This modular approach has expanded to include integration with subcutaneous implantable cardioverter-defibrillators and leadless cardiac resynchronization therapy, moving towards a fully leadless cardiac rhythm management ecosystem. This review summarizes the evolution of leadless pacing, compares currently available devices and their clinical applications, explains leadless pacemaker implantation and end-of-life management, and explores the modular leadless pacing concept as the foundation for future fully leadless cardiac rhythm management.
SN - 2077-0383
ER -